I have a Resident in an assisted living LTC that claims to be in constant pain and requests pain control every 4 hours like clock work.
She has been examined by multiple doctors and had every diagnostic test known to man, all of which found minimal (if any) pathology of any kind. She was found to have a small benign growth. She has been on multiple trials of multiple Rx's, including antibiotics for "suspected" UTIs.
Her most common complaint is of abdominal and inguinal area pain. She was complaining of burning and tingling in her arms and legs when I first began working with her. I suspected a B12 deficiency, among other possible reasons, but according to her paperwork from her recent stay in the hospital, all suspected causes checked out.
She has been to at least 4 doctors in 4 months, and has "fired" all of them. She has found one that is putting her through further testing, and she seems to be happy with him...for now.
Until recently, I have always taken her complaints very seriously, as I feel one should when they are dealing with anyone in their care. I would be offended by my coworkers, who called her a "hypochondriac" and say that she was simply addicted to Tylenol.
Looking at her chart and seeing her hx of TIA, I assumed it was entirely possible that she had PAD, which could possibly explain her severe leg pain. It was certainly *possible*. I considered cramping due to mineral deficiencies, and of course, a B12 deficiency. All results were within normal range, but I had no data to rule out PAD. There are other possible causes as well of course.
The point was, everyone else dismissed this lady's claims of pain, which I thought was unprofessional and even dangerous. Even those who call wolf can end up really needing help.
Normally when I work with this woman, she is moaning and groaning asking for pain control every 4 hours like clock work. She is given Tylenol PRN in addition to her regular HS meds (I work the night shift).
To me, it seems like she is genuinely in pain.
A few days ago, she was NPO overnight to prepare for her scope. Each time I checked on her, she seemed fine. She mentioned that she knew she was to avoid Tylenol/more than a sip of water if possible. I found it strange that she seemed perfectly fine, but thought that perhaps she was having a "good" night.
2 days later, I saw that her room was rearranged. It had never crossed my mind that SHE had done this herself. I was told this the next morning. I though this was odd, considering that she is supposedly always in so much pain. Of course, she was calling me for Tylenol due to "severe back pain" that night.... Odd no matter how you look at it...
Last shift she complained that she could not empty her bladder, and had severe pain. It did feel like her bladder was distended and full. Her vitals were within normal range, and she didn't have a fever. She had just finished her 3rd course of antibiotics a "suspected" bladder infection.
She again appeared to be genuinely in pain, but for some reason, near the end of my shift, I couldn't help but wonder if this whole time she's been "faking it". It's not going to affect my interactions with her of course, or her care, but I want to know if I'm being naive or doing the right thing by taking her more seriously than my coworkers. I want to make sure she is getting proper care, but I don't want to be getting sucked in either....
